1. Sound policy and plan formulation

2. 2 Policy and planning Key messages Policy process is messy, but there are elements of good practice you can use. 1.Sound processes 2.Realism 3.Comprehensive and balanced content 4.Linkage with health programs 5.Linkage with medium-term and subnational plans Policy dialogue needs a range of skills

3. 3 Policy and planning Policy dialogue Policy dialogue includes analysis and advice that is: accurate, timely and well informed politically astute, and based on broad consultation

4. 4 Policy and planning Good policy advice is grounded in the big picture focuses on the ‘customer’ comes from a strong analytical foundation rests on a substantial evidence-base appreciates the value of engagement, and builds-in systematic evaluation

5. 5 Policy and planning Policy dialogue skills More than technical expertise. Specific skills needed in:  rigorous problem identification  identifying options  applying analytical frameworks, and  preparing clear advice. Broad skills needed in:  relationship building, negotiating, influencing, and  aligning governance, strategy, policy, management and service delivery.

6. 6 Policy and planning Policy process and planning are messy Idealized Real-life

7. 7 Policy and planning Good policy and planning practice 1.Sound processes 2.Realism 3.Comprehensive and balanced content 4.Linkage with health programs 5.Linkage with medium-term and subnational plans Ref - A framework for national health policies, strategies and plans June 2010

8. 8 Policy and planning 1. Sound processes in all steps Situation analysis Implementation & monitoring Evaluation & feedback Plan formulation Priority setting Costing & budgeting

9. 9 Policy and planning 2. Realism: … the people who will implement the plans are involved in the planning decisions … plans are within the sector’s resources, capacities, and constraints … plans address the concerns of the implementing and middle management of the health sector … plans have political commitment and buy-in of stakeholders with competing interests Plans are more likely to be implemented if: …

10. 10 Policy and planning 3. Comprehensive and balanced content A national health plan should address i. Vision, values, goals, inter-sectoral approaches ii. A robust situation analysis iii. Possible policy directions for:  improving health equity  making services people-centered  protecting and promoting the health of communities iv. A comprehensive strategy, with associated costs, to respond to challenges and implement the plan v. Financing and management arrangements, audit, procurement and monitoring arrangements

11. 11 Policy and planning 4. Linkage with programs - coherence Coherent health planning is more than the sum of programme plans such as MCH, TB, HIV … Coherence requires:  Inclusive policy dialogue  each programme’s concerns are reflected in the national health plan  programme plans are based on realistic assessments of their use of shared system resources

12. 12 Policy and planning 4. Linkage with programs - coherence Coherence means: The relative priorities of the different programmes are set in line with the BoD and overall sector priorities The objectives of the different programmes are consolidated to assist implementation of service delivery The use of shared system resources by different programmes is within the capacity of relevant levels Programme monitoring requirements: are included in the routine health information system, and/or monitoring labour & costs are feasible

13. 13 Policy and planning How does a clinic nurse cope without coherence? DEVELOPMENT PARTNERS NATIONAL AIMAG SOUM HEALTH CENTRE CLINIC or NURSE STATION COMMUNITY WHO UNICEF GIZ EPI Canc er TB ORAL HEALTH RH OTHERS HAC World Bank DFID ADB GFATM UNFPA Under funded Too much information Too many trainings HIV/AIDS Diabetes Inadequate logistics Too many requirements Understaffed Conflicting priorities Too many meetings orld Vision

14. 14 Policy and planning 5. Linkage with medium term & subnational plans Medium Term Expenditure Framework consists of: –top-down multi-year projection of resource envelope (funds available) –bottom-up multi-year cost estimates for programmes (funds needed) –Trade-offs: the political / administrative process to reconcile the two Linkage with operational plans depends on the level of detail in the national strategic plan, and autonomy or decentralization at different operational levels.

15. 15 Policy and planning More than the sum of programme plans such as MCH, TB, NCDs … Blueprints won't work It is not only the "plan”. The process is as important! … but the process is usually messy… This is why inclusive policy dialogue is key Idealized Real-life Planning is messy

16. 16 Policy and planning 1. Sound processes 2. Realism 3. Comprehensive and balanced content 4. Linkage with health programs 5. Linkage with medium-term and sub- national plans Good policy and planning practice

17. Thank you